Abraham Verghese - Cutting for Stone

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Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon at a mission hospital in Addis Ababa. Orphaned by their mother’s death in childbirth and their father’s disappearance, bound together by a preternatural connection and a shared fascination with medicine, the twins come of age as Ethiopia hovers on the brink of revolution. Yet it will be love, not politics—their passion for the same woman—that will tear them apart and force Marion, fresh out of medical school, to flee his homeland. He makes his way to America, finding refuge in his work as an intern at an underfunded, overcrowded New York City hospital. When the past catches up to him—nearly destroying him—Marion must entrust his life to the two men he thought he trusted least in the world: the surgeon father who abandoned him and the brother who betrayed him.

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No one but Ghosh dared touch the Koot. Cables ran from its giant rectifier to the Coolidge tube, which sat on a rail and could be moved this way and that. He worked the dials and voltage levers until a spark leaped across the two brass conductors, producing a thunderclap. The fiery display had caused one paralyzed patient to leap off the stretcher and run for his life; Ghosh called that the Sturm und Drang cure. He was the Koot's keeper, repairing it, babying it so that three decades after the company went under, the Koot was still operational. Using the fluo-roscopy screen, he studied the dancing heart, or else he defined exactly where a cavity in the lung resided. By pushing on the belly he could establish whether a tumor was fixed to the bowel or abutted on the spleen. In the early years he hadn't bothered with the lead-lined gloves, or a lead apron for that matter. The skin of his probing, intelligent hands paid a visible price.

HEMA TRIED TO IMAGINE Ghosh telling his family about her. She's twenty-nine. Yes, we were classmates at Madras Medical School, but she's a few years younger. I don't know why she never married. I didn't get to know her well till we were interns in the septic ward. She's an obstetrician. A Brahmin. Yes, from Madras. An expatriate, living and working in Ethiopia these eight years. Those were the labels that defined Hema, and yet they revealed little, explained nothing. The past recedes from a traveler, she thought.

Sitting in the plane, Hema closed her eyes and pictured her schoolgirl self with the twin ponytails, the long white skirt, and white blouse under the purple half sari. All Mrs. Hood Secondary School girls in Mylapore had to wear that half sari, really nothing more than a rectangle of cloth to coil around the skirt once and pin on the shoulder. Shed hated it, because one was neither child nor adult but half woman. Her teachers wore full saris while the venerable headmistress, Mrs. Hood, wore a skirt. Hema's protests triggered a lecture by her father: Do you not know how fortunate you are to be in a school with a British headmistress? Do you not know how many hundreds have tried to get in there, offered ten times the money, but were turned down by Miz-Iz-Ood. She goes by merit only. Would you prefer the Madras corporation school? And so, each day she put on the hated uniform, feeling half dressed, and feeling as if she were selling a piece of her soul.

Velu, the neighbor's son whod once been her best friend, but who had turned insufferable at ten, liked to perch on the dividing wall and tease her:

The girls who come from Miz-Iz-Ood, parlez-vous?

The girls who come from Miz-Iz-Ood, parlez-vous?

The girls who come from Miz-Iz-Ood,

Haven't grown their womanhood,

Inky Pinky parlez-vous!

She ignored him. Velu, who was as dark-skinned as she was light, said, “So proud you are of being fair. Monkeys will nibble your sweet flesh thinking it is jackfruit on a jackfruit tree, mind you me!” There she was, eleven years old, setting off for school, dwarfed by her Raleigh bicycle, trading barbs with Velu. Her books were in a tasseled sanji slung over her shoulder, the strap running between her breasts. Already in her posture and in her steady pedal strokes there were signs of a certain immutability.

The bicycle, once so tall and perilous, soon shrunk beneath her. Her breasts thrust out on either side of that sanji strap, and hair sprouted between her legs. (If that was what Velu had meant about not growing her womanhood, she had proved him wrong.) She was a good student, a captain in net ball, a senior prefect, and showing promise in Bharat-natyam, finding in herself a talent for recapitulating a most intricate dance sequence after being shown it just once.

She felt neither an obligation to join the herd nor any urge to try to stand out from it. When a close friend told her she always looked cross, she was surprised and a little thrilled that she could pull off such mis direction. In medical school (in full sari and now riding the bus) this quality grew stronger—not crossness, but independence and misdirection. Some classmates considered her arrogant. She drew others to her like aco lytes only for them to discover she wasn't recruiting. The men needed pliancy in their women friends, and she couldn't bring herself to act coy or silly for their sakes. The couples who huddled in the library behind oversize anatomy atlases and whispered themselves into the notions of love amused her.

I had no time for such silliness. But she did have time for trashy novels set in castles and country houses with heroines named Bernadette. She fantasized about the dashing men of Chillingforest and Lockingwood and Knottypine. That was her trouble then—she dreamed of a greater kind of love than the kind displayed in the library But she was also filled with a nameless ambition that had nothing to do with love. What exactly did she want? It was an ambition that wouldn't let her compete for or seek the same things others sought.

When, as a student at Madras Medical College, Hema had found herself admiring her professor of therapeutics (the lone Indian in a school where, even as independence approached, most of the full professors were British), when she found herself moved by his humanity his mastery of his subject (Face it, Hema; it was a crush), when she found herself wishing to be his understudy and found him encouraging, she deliberately chose another path. She was loath to give anyone that kind of power. She chose obstetrics and gynecology instead of his field, internal medicine. If the professor's field was limitless, requiring a breadth of knowledge that extended from heart failure to poliomyelitis and myriad conditions in between, she chose a field that had some boundaries and a mechanical component—operations. Of these there was a limited repertoire: C-sections, hysterectomies, prolapse repair.

She'd discovered in herself a talent for manipulative obstetrics, becoming expert at divining just how the baby was hung up in the pelvis. What other obstetricians perhaps dreaded, she relished. Blindfolded, she could distinguish the left from the right forceps and apply each in her sleep. She could see in her mind's eye the geometry of each patient's pelvic curve and match that to the curvature of the baby's skull as she slid the forceps in, articulating the two handles and confidently extracting the baby.

She went overseas on a whim. But it broke her heart to leave Madras. She still cried some evenings, picturing her parents taking their chairs outdoors to wait for the sea breeze which, even on the hottest and stillest of days, blew in at dusk. She left because gynecology, at least in Madras, remained a man's domain, and, even on the eve of independence, a British domain, and she had no chance at all for a civil service appointment to the government teaching hospital. It was strange and yet it pleased her to think that she, Ghosh, Stone, and Sister Mary Joseph Praise had all at one time or another trained or worked at the Government General Hospital in Madras. A thousand five hundred beds and twice that number under the beds, between the beds—it was a city by itself. In it Sister Mary Joseph Praise had been a budding novitiate and probationer; perhaps theyd even walked past each other. And incredibly, Thomas Stone, too, had a brief tenure at Government General Hospital, though since the maternity section was quite separate, thered been no reason for his path to cross with Hema's.

Shed left behind Madras, left behind labels of caste, gone so far away that the word “Brahmin” meant nothing. Working in Ethiopia, she tried to make a visit home every third or fourth year. She was returning after her second such visit. Seated in the noisy airplane, she found herself rethinking her choices. In the last few years shed come close to defining the nameless ambition that had pushed her this far: to avoid the sheep life at all costs.

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